脑炎治疗——一例脑脊液中EBV PCR长期随访的病例报告
Encephalitis treatment - a case report with long-term follow-up of EBV PCR in cerebrospinal fluid.
作者信息
Zarlasht Fnu, Salehi Mashal, Abu-Hishmeh Mohammad, Khan Muzammil
机构信息
Department of Medicine, Lourdes Hospital, Binghamton, NY, USA.
Department of Medicine, NYC Health + Hospital/Harlem, Columbia University, NY, USA.
出版信息
Int J Gen Med. 2017 Oct 26;10:371-373. doi: 10.2147/IJGM.S143335. eCollection 2017.
BACKGROUND
Epstein-Barr virus (EBV) has been found to cause infectious mononucleosis multiple times, but has been associated rarely with EBV encephalitis. Also, whenever it is diagnosed, it is always treated symptomatically.
CASE REPORT
A case of confirmed EBV encephalitis is presented, which was treated with antiviral therapy resulting in complete clearance of the virus in cerebrospinal fluid and minimal neurologic symptoms after hospital discharge.
CONCLUSION
The Infectious Diseases Society of America guidelines state that intravenous acyclovir is not recommended for EBV-related encephalitis. But we reviewed the literature and found similar cases, and we believe that antiviral therapy should be recommended for EBV encephalitis because it is a potentially fatal disease and if left untreated, can lead to raised intracranial pressure, craniotomy and even death.
背景
已多次发现爱泼斯坦-巴尔病毒（EBV）可引起传染性单核细胞增多症，但很少与EBV脑炎相关。而且，一旦确诊，通常都进行对症治疗。
病例报告
本文介绍了一例确诊的EBV脑炎病例，该病例接受了抗病毒治疗，脑脊液中的病毒得以完全清除，出院后神经症状轻微。
结论
美国传染病学会指南指出，不建议对EBV相关脑炎使用静脉注射阿昔洛韦。但我们查阅文献后发现了类似病例，我们认为EBV脑炎应推荐抗病毒治疗，因为它是一种潜在的致命疾病，若不治疗，可导致颅内压升高、开颅手术甚至死亡。
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